COMMISSION ON FILIPINOS OVERSEAS

INFORMATION SHEET FOR FILIPINO IMMIGRANT WORKERS PHOTO

INSTRUCTIONS : Please PRINT letters in the spaces provided.

Please CHECK (3) appropriate box(es).

(FOR CFO USE ONLY)

CFO No. / Emigrant No.

OR #

Category

Reg. Date [ mm-dd-yyyy ] - -

Verifier

PERSONAL DATA
Last Name Suffix

First Name

Middle Name
If married, please state mother's maiden name

DATE OF BIRTH [ mm-dd-yyyy ] AGE SEX CIVIL STATUS † Single

✔
† Married
† Male † Female
✔
† Divorced † Widow(er) † Separated
PLACE OF BIRTH † Outside of the Philippines
Town / City

Province

ADDRESS & CONTACT NUMBERS IN THE PHILIPPINES

House No. / Street / Barangay

Town / City

Province Zip Code

Telephone Number Cellphone Number

E-mail Address

ADDRESS & CONTACT NUMBERS (Country of Destination)

House No. / Street

City / State

Country Zip Code

Telephone Number Cellphone Number

PASSPORT NUMBER DATE OF ISSUE [ mm-dd-yyyy ]

VISA NUMBER DATE OF ISSUE [ mm-dd-yyyy ]

HIGHEST EDUCATIONAL ATTAINMENT

† Elementary Level † Vocational Level † Post Graduate Level † Not of schooling age
† Elementary Graduate † Vocational Graduate † Post Graduate ( Below 7 yrs old )
† High School Level † College Level † No Formal Education
† High School Graduate † College Graduate
✔
† Others
If vocational / college / post graduate, state course

Revised as of March 2009 THIS FORM IS NOT FOR SALE

www.cfo.gov.ph
 OCCUPATION ( as stated in contract )

SALARY

DATA OF NEAREST FAMILY MEMBER IN THE PHILIPPINES

Last Name Suffix

First Name

Middle Name Relationship

House No. / Street / Barangay

Town / City

Province Zip Code

Telephone Number Cellphone Number E-mail Address

CONTRACT INFORMATION

RECRUITER'S DATA † PHILIPPINE-BASED † FOREIGN-BASED

NAME OF RECRUITING COMPANY / AGENCY / CONSULTANT

CONTACT PERSON

POSITION E-MAIL ADDRESS

NUMBER / BUILDING / STREET

CITY / STATE ZIP CODE

TELEPHONE NUMBER CELLPHONE NUMBER PLACEMENT FEE

EMPLOYER'S DATA

NAME OF EMPLOYER ABROAD

CONTACT PERSON

POSITION E-MAIL ADDRESS

NUMBER / BUILDING / STREET

CITY / STATE

COUNTRY ZIP CODE

TELEPHONE NUMBER CELLPHONE NUMBER

CERTIFICATION
I hereby certify under penalty of law to the truth and correctness of the statement and that this
form was accomplished by me personally or under my personal direction.

SIGNATURE ABOVE PRINTED NAME

Revised as of March 2009 THIS FORM IS NOT FOR SALE

www.cfo.gov.ph